Heart Failure with Preserved Left Ventricular Ejection Fraction in Patients with Acute Myocardial Infarction

Background: The prevalence and clinical outcomes of heart failure with preserved left ventricular ejection fraction after acute myocardial infarction have not been well elucidated. Objective: To analyze the prevalence of heart failure with preserved left ventricular ejection fraction in acute myocardial infarction and its association with mortality. Methods: Patients with acute myocardial infarction (n = 1,474) were prospectively included. Patients without heart failure (Killip score = 1), with heart failure with preserved left ventricular ejection fraction (Killip score> 1 and left ventricle ejection fraction ≥ 50%), and with systolic dysfunction (Killip score> 1 and left ventricle ejection fraction < 50%) on admission were compared. The association between systolic dysfunction with preserved left ventricular ejection fraction and in-hospital mortality was tested in adjusted models. Results: Among the patients included, 1,256 (85.2%) were admitted without heart failure (72 % men, 67 ± 15 years), 78 (5.3%) with heart failure with preserved left ventricular ejection fraction (59 % men, 76 ± 14 years), and 140 (9.5%) with systolic dysfunction (69 % men, 76 ± 14 years), with mortality rates of 4.3%, 17.9%, and 27.1%, respectively (p < 0.001). Logistic regression (adjusted for sex, age, troponin, diabetes, and body mass index) demonstrated that heart failure with preserved left ventricular ejection fraction (OR 2.91; 95 % CI 1.35–6.27; p = 0.006) and systolic dysfunction (OR 5.38; 95 % CI 3.10 to 9.32